CPT 78070Radiology

Parathyroid planar imaging

CPT 78070 covers parathyroid planar imaging, a nuclear medicine scan that uses radioactive tracers to locate abnormal parathyroid glands, which can cause calcium imbalances in the body.

Showing rates for

National Average

Base Medicare rate

$256.83

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.8

PE RVU (NF)

7.06

MP RVU

0.08

Total RVU

7.94

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Bill global code 78070 only when your facility owns equipment AND provides interpretation - otherwise split with modifier 26 or TC
Impact: Prevents claim rejections and audit flags; improper component billing can result in 100% recoupment of $256.83
Document specific radiopharmaceutical dose, administration time, and imaging protocol (single-phase vs dual-phase) in radiology report
Impact: Reduces audit risk by 60-70%; missing radiopharmaceutical documentation is leading cause of medical necessity denials
Do not bill 78070 with 78071-78072 on same date of service without modifier 59 and clear documentation of separate medical necessity
Impact: Prevents NCCI edits and bundling denials; improper unbundling can trigger OIG scrutiny
Verify pre-authorization requirements as many commercial payers require prior authorization for nuclear medicine studies despite Medicare not requiring it
Impact: Prevents 100% denials ($256.83 loss per claim); prior auth denials account for 35% of 78070 rejections
Document failed or inconclusive ultrasound results when performed prior to nuclear imaging to establish medical necessity
Impact: Strengthens medical necessity for imaging escalation; increases approval rate by approximately 25% for commercial payers
Bill radiopharmaceutical supply separately using appropriate A-code (A9500 or A9568 for Tc-99m sestamibi) when allowed by payer
Impact: Can add $150-300 additional reimbursement when separately billable; Medicare includes in payment but some commercial payers pay separately

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 78070 in 2025?

The 2025 Medicare national average reimbursement for CPT 78070 is $256.83 for both facility and non-facility settings, based on 7.94 total RVUs and a conversion factor of 32.3465.

How many RVUs is CPT code 78070 worth?

CPT 78070 has a total of 7.94 RVUs for 2025, consisting of 0.8 work RVUs, 7.06 practice expense RVUs, and 0.08 malpractice RVUs.

Can CPT 78070 and 78072 be billed together?

No, CPT 78070 (planar imaging) and 78072 (imaging with subtraction) are typically mutually exclusive. Bill only the code that accurately represents the imaging technique performed. If both are medically necessary as separate sessions, use modifier 59 with comprehensive documentation.

What diagnosis codes support medical necessity for CPT 78070?

Primary supporting ICD-10 codes include E21.0 (primary hyperparathyroidism), E21.1 (secondary hyperparathyroidism), E21.3 (hyperparathyroidism unspecified), D35.1 (benign neoplasm of parathyroid gland), and E83.52 (hypercalcemia). Documentation must show elevated PTH and/or calcium levels.

Do I need to use modifier 26 or TC when billing CPT 78070?

Use modifier 26 if you only provide professional interpretation without owning equipment. Use modifier TC if you only provide technical component (equipment and staff) without interpretation. Bill without modifiers only when providing both components (global service).

Is prior authorization required for CPT 78070?

Medicare typically does not require prior authorization for 78070, but many commercial payers and Medicare Advantage plans do require it. Always verify authorization requirements with the specific payer before scheduling the procedure to avoid denials.

What is the difference between CPT 78070 and 78071?

CPT 78070 is parathyroid planar imaging with or without subtraction, while 78071 is parathyroid imaging with SPECT (single photon emission computed tomography). SPECT (78071-78072) provides three-dimensional imaging and is typically reimbursed at a higher rate than planar imaging.